To understand the blood tests better and see a further explanation of her situation, click "Read More"
More about blood tests...
The two tests we are running are called ESR and CRP. You can click the links to read more about each one. But the basics are this: they are both general markers, meaning they do not provide specific diagnoses but are rather indicators for the levels of inflammation and infection in the body. (Some people may know ESR as sed-rate.) While they test for similar things, the results from the two tests tend to differ in their progressions. In visual terms, it looks like this:
ESR _______ / \ / \ / \ | | | | | CRP /\ / \ / \ / \ / \ |
As you can sortof see by this rough illustration, changes in the sed-rate tend to take longer - it could be weeks to months before we finally see it go down. It also tends to be less specific, working in ranges of numbers as opposed to specifics. (For example, 80-100 is considered all the same level.) However, the CRP has a sharper change to it and reacts quickly. Because of these differences, Katelyn's doctors are much more concerned with her CRP levels, the big question being, "Are they trending downwards?"
As of today, her CRP has dropped by almost 2.5 points to a 6.5! That's great news, on one hand, because it does appear to be trending downwards, although my Math teachers always taught us it takes 3 to make a pattern. On the other hand, it is still quite elevated considering normal is zero and they won't even consider sending her home until we are at 2.0. Katelyn's ESR levels have fluctuated within the same general range, going from well over 100 in Nac down to 89 after her surgery and back up to 106+/- this morning. But since they're all in the same range, it's as if there were no real change.
what does all this mean for Katelyn?
The bottom line of the tests this morning combined with her physical progress is this: she seems to be improving, but we are still here and will be for at least 2-4 more days. Early Thursday morning we will repeat the blood test and see where her levels are then. If they're low enough, we may get to come home. But there are lots of other factors weighing in on that decision, too, and our main concern is that Katelyn gets the treatment she needs. So we will be here as long as we need to be.
did they catch all the infection?
The next major question in my mind has been the possibility of having not removed all the infection. We were told at the start that sometimes children appear to improve in the first few days only to start seeing limited range of motion in the affected limbs again and/or elevated or climbing ESR and CRP levels. We asked about this possibility this morning and her peds resident said today, tomorrow, and Thursday would be the prime time for a relapse, so we are watching her carefully for any signs. But right now, she is doing great!
what about long-term effects?
That has been a big question on our minds - we have broached the subject with her doctors, none of whom seem ready to discuss it yet, but they've tried to put our minds at ease about it. Her ortho surgeon told us this morning that she will not need any physical therapy, despite needing up to several weeks - months to regain full range of motion in her left leg. We've also been concerned about the possibility of recurrence and that is where the doctor's are less sure. Some children never have another issue and it seems others can see the same problems over and over in the future. I'm not sure if there's any way to predict what Katelyn's future will hold.
Again, thank you all for your prayers - and for telling us you're praying. It has been an amazing comfort to us, overwhelming really, to realize how many people from all over the world are praying for our precious little girl. God's ears must be ringing with her name these last few days! Thank you so much for praying with us!
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